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The Time of Cheer: Managing Seasonal Depression as We Enter a Quiet Winter

December 16, 2020 | Behavioral Health Services | Dsouza, Allen, MD


We’ve approached a time of year that’s challenging for many of us, with short daylight hours and the emotions of the holiday season that may cause feelings of being down. A conversation about depression may be extra warranted this winter as we learn more about the lasting effects of COVID-19. Sandeep Bansal, MD, director of the Lung Center at Penn Highlands and the Penn Highlands DuBois intensive care unit, has noted depression as one of the symptoms for many COVID-recovered patients who are experiencing what he refers to as “post-COVID syndrome.” Wider trends reflect this, as last month NPR reported that approximately 20 percent of COVID-19 patients are reporting psychiatric disorders like depression, anxiety, and insomnia after they recover from the virus.

Allen Dsouza, MD, a psychiatrist at Penn Highlands Behavioral Health Services, adds that in a season which can bring on the blues even in the cheeriest of winters, individuals should consider making a very intentional commitment to self-care these next few months. “There is existing data that suggests there might be a rise in suicidal ideations,” Dsouza says. “That’s one of the worrying trends.” Dsouza cites a study in Australia that pointed to a near-40 percent increase in calls to a suicide hotline in recent months. Closer to home, he says the effect appears similar: “We are noticing a rise in patients coming to the emergency department with suicidal thoughts.”

What’s up with this downswing in our moods? “We are social animals,” Dsouza says. “In times of stress, we rely on contact with other human beings. When that socialization is restricted, this could contribute to or exacerbate depression. He also mentions a sense of worry or nervousness about the future for an individual who hears about others losing jobs, the rising number of positive cases, or the loss of loved. “It may cause us to think, ‘This might happen to me’” Dsouza says. “Eventually a sense of helplessness could develop and lead to a depressed mood.”

Whether it’s seasonal patterns, a traumatic event that triggers hopeless feelings or a state of depression related to the pandemic, Dsouza advises that for many of us it will be important to seek clinical help during this time. “There are issues we can help with as behavioral health professionals,” he says. “We can examine the circumstances for each patient, because the treatment is completely different depending on the cause.” In the meantime, he makes a few recommendations here.

For individuals who experience depression related to the winter season, Dsouza mentions light therapy, also called light boxes—and he points out that it’s important to choose the appropriate light, as some can affect the eyes or skin. “A light box needs to be safe for the eye, especially keeping in mind older adults who might have preexisting conditions such as glaucoma or cataract.” He notes that therapists usually consult with an ophthalmologist or get in touch with the patient’s primary care provider to determine whether any other conditions need to be taken into account.

For folks who already see a therapist, Dsouza says they may want to increase the frequency of those appointments. “If you see them once every three weeks, maybe you need to see them weekly or biweekly, at least.” For those already on psychiatric medications, their psychiatrist can adjust those if this is a stressful time.

For all of us, Dsouza says it’s important to pick a feel-good habit and stick with it. “During this time with the weather and when it’s darker—and now adding these restrictions for socialization—initially it might feel good to avoid doing something for someone who is depressed this time of year,” he explains. “If we feel sad, we might say to ourselves, ‘I feel better not doing this.’ But that gets into this vicious cycle where the avoidance increases and then worsens the mood and depression.” Anyone who’s ever dodged a workout and then realized how positive it feels to get back into that routine might relate to this. Dsouza says exercising at home can be a good option even when gym attendance is restricted (“Exercise releases some amount of endorphins which help to relieve depression,” he says), and there are other habits he encourages, too. Dsouza notes that some professionals recommend a cognitive behavioral therapy technique called an ”action prescription.” Pick a pleasurable activity, and even set a reminder on your phone or calendar or refrigerator. ”Call your friend,” Dsouza says. “Check on family members or a neighbor. Walk in your yard, or cook something that makes you happy. Just make sure you do it.”

For those grieving the loss of a loved one, Dsouza recommends Brook Noel’s I Wasn’t Ready to Say Goodbye, a self-help book about coping after the sudden death of a loved one. People who seek psychiatric care can discuss other options with their primary care provider, such as asking whether their diet—and their mood—could use a boost from Vitamin D. “It’s not as effective as light therapy results,” he says, “but we’ve seen it does help when we don’t get much exposure to sunlight.”

Dsouza emphasizes that the most important thing to remember is that if you’re struggling, do not hesitate to reach out and get help—and, have hope. Life will look different when the COVID-19 vaccines are available, as frontline workers are expected to receive them within the next couple weeks. For more wellness content and to find the care you need this winter, please visit us at www.phhealthcare.org. For mental health needs, see us at www.phhealthcare.org/bhs.


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Dsouza, Allen, MD

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Psychiatry - Child/Adolescent

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Behavioral Health Services